Provider Demographics
NPI:1689981268
Name:KEDDIE- HIGGINS, ALLISON J (LMHC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:J
Last Name:KEDDIE- HIGGINS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:KEDDIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:3176 ABBOTT RD
Mailing Address - Street 2:BUILDING A, SUITE 500
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1069
Mailing Address - Country:US
Mailing Address - Phone:716-822-2117
Mailing Address - Fax:716-822-8165
Practice Address - Street 1:3176 ABBOTT RD
Practice Address - Street 2:BUILDING A, SUITE 500
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1069
Practice Address - Country:US
Practice Address - Phone:716-822-2117
Practice Address - Fax:716-822-8165
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY005555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health